Mao Song, Huang Songming
Department of Nephrology, Nanjing Children's Hospital of Nanjing Medical University, Nanjing, China.
Scand J Infect Dis. 2013 Sep;45(9):696-702. doi: 10.3109/00365548.2013.803293. Epub 2013 Jul 2.
It is well-documented that serum levels of 25-hydroxyvitamin D (25-OHD) are inversely associated with the risk of respiratory tract infections (RTIs). However, whether or not vitamin D supplementation prevents RTIs remains inconclusive. The aim of this study was to evaluate the role of vitamin D supplementation in preventing RTIs in healthy populations by performing a meta-analysis of randomized controlled trials (RCTs).
RCTs regarding the association between vitamin D supplementation and the risk of RTIs were identified by searching PubMed, Embase, and Cochrane databases through January 2013. Reference lists of retrieved articles were also reviewed. Either a fixed-effects or, in the presence of heterogeneity, a random-effects model was used to calculate the pooled preventive effects.
Seven RCTs involving 4827 participants were included in this meta-analysis. The pooled relative risk (RR) for subjects administered with vitamin D compared with control groups was 0.98 (95% confidence interval 0.93-1.03, p = 0.45). Meta-regression analyses showed almost no impact on the RR of age, vitamin D dosing regimen, and length of follow-up. Omission of any single trial had little impact on the pooled risk estimates. No evidence of publication bias was observed.
Our findings do not support the routine use of vitamin D supplementation for RTI prevention in healthy populations. Larger studies are needed to investigate the effects of vitamin D supplementation on RTI prevention in various populations and to further clarify the influences of age, vitamin D dosing regimen, baseline levels of vitamin D, and study length.
有充分文献记载,血清25-羟维生素D(25-OHD)水平与呼吸道感染(RTIs)风险呈负相关。然而,维生素D补充剂是否能预防RTIs仍无定论。本研究旨在通过对随机对照试验(RCTs)进行荟萃分析,评估维生素D补充剂在预防健康人群RTIs中的作用。
通过检索截至2013年1月的PubMed、Embase和Cochrane数据库,确定关于维生素D补充剂与RTIs风险之间关联的RCTs。还对检索文章的参考文献列表进行了审查。采用固定效应模型或在存在异质性时采用随机效应模型来计算合并预防效果。
本荟萃分析纳入了7项涉及4827名参与者的RCTs。与对照组相比,服用维生素D的受试者的合并相对风险(RR)为0.98(95%置信区间0.93 - 1.03,p = 0.45)。荟萃回归分析显示,年龄、维生素D给药方案和随访时间对RR几乎没有影响。省略任何一项试验对合并风险估计的影响很小。未观察到发表偏倚的证据。
我们的研究结果不支持在健康人群中常规使用维生素D补充剂来预防RTIs。需要开展更大规模的研究来调查维生素D补充剂对不同人群RTIs预防的影响,并进一步阐明年龄、维生素D给药方案、维生素D基线水平和研究时长的影响。